Prenatal counseling for extreme prematurity at the limit of viability: A scoping review

Proost, Lien De; Geurtzen, Rosa; M’hamdi, Hafez Ismaili; Steegers, Eric A.P.; Verweij, E. J.

doi:10.1016/j.pec.2021.10.033

Cited by 18 publications

(20 citation statements)

References 38 publications

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“…However, it is of great importance to adjust the counselling by taking into consideration the parental values and ideas about quality of life. 29 30 As such, the National Institute of Child Health in the UK advises to ‘individualise the information to be provided, based on family preferences, wants and needs’. 31 Further exploration is needed on parental views of personalising prenatal counselling and on exactly what aspects of prenatal counselling should be personalised.…”

Section: Discussionmentioning

confidence: 99%

“…31 Further exploration is needed on parental views of personalising prenatal counselling and on exactly what aspects of prenatal counselling should be personalised. 29 …”

Section: Discussionmentioning

confidence: 99%

“…The current study presents data on neurodevelopmental outcome after preterm birth that can be used for prenatal counselling of parents. However, it is of great importance to adjust the counselling by taking into consideration the parental values and ideas about quality of life 29 30. As such, the National Institute of Child Health in the UK advises to ‘individualise the information to be provided, based on family preferences, wants and needs’ 31.…”

Section: Discussionmentioning

confidence: 99%

“…31 Further exploration is needed on parental views of personalising prenatal counselling and on exactly what aspects of prenatal counselling should be personalised. 29 The strengths of this study include the high follow-up rate (85%), the national approach and the extensive data collection over a period of 3 years in a contemporaneous cohort. Follow-up was performed in a standardised way during regular outpatient clinic visits using a nationwide guideline.…”

Section: Original Researchmentioning

confidence: 99%

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Two-year neurodevelopmental outcome in children born extremely preterm: the EPI-DAF study

Beek

Rijken

Broeders

et al. 2022

Arch Dis Child Fetal Neonatal Ed

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ObjectiveIn 2010, the Dutch practice regarding initiation of active treatment in extremely preterm infants was lowered from 25 completed weeks’ to 24 completed weeks’ gestation. The nationwide Extremely Preterm Infants – Dutch Analysis on Follow-up Study was set up to provide up-to-date data on neurodevelopmental outcome at 2 years’ corrected age (CA) after this guideline change.Design: National cohort study.PatientsAll live born infants between 240/7 weeks’ and 266/7 weeks’ gestational age who were 2 years’ CA in 2018–2020.Main outcome measureImpairment at 2 years’ CA, based on cognitive score (Bayley-III-NL), neurological examination and neurosensory function.Results651 of 991 live born infants (66%) survived to 2 years’ CA, with data available for 554 (85%). Overall, 62% had no impairment, 29% mild impairment and 9% moderate-to-severe impairment (further defined as neurodevelopmental impairment, NDI). The percentage of survivors with NDI was comparable for infants born at 24 weeks’, 25 weeks’ and 26 weeks’ gestation. After multivariable analysis, severe brain injury and low maternal education were associated with higher odds on NDI. NDI-free survival was 48%, 67% and 75% in neonatal intensive care unit (NICU)-admitted infants at 24, 25 and 26 weeks’ gestation, respectively.ConclusionsLowering the threshold has not been accompanied by a large increase in moderate-to-severely impaired infants. Among live-born and NICU-admitted infants, an increase in NDI-free survival was observed from 24 weeks’ to 26 weeks’ gestation. This description of a national cohort with high follow-up rates gives an accurate description of the range of outcomes that may occur after extremely preterm birth.

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Section: Discussionmentioning

confidence: 99%

“…31 Further exploration is needed on parental views of personalising prenatal counselling and on exactly what aspects of prenatal counselling should be personalised. 29 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Original Researchmentioning

confidence: 99%

See 2 more Smart Citations

Two-year neurodevelopmental outcome in children born extremely preterm: the EPI-DAF study

Beek

Rijken

Broeders

et al. 2022

Arch Dis Child Fetal Neonatal Ed

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show abstract

“…Culture and social background should also be taken into consideration, as well as level of understanding (26). Personalization is probably the most important aspect and should be applied to all parts of antenatal care (23) (24). Learning how to identify parents' wishes should be a part of residents' training as it is not an easy task.…”

Section: Discussionmentioning

confidence: 99%

Qualitative analysis of mothers’ perception related to the delivery of information surrounding premature births

Randriamboarison¹,

Fustec²,

Enderlé³

et al. 2023

Preprint

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Background: Prematurity is a major health issue due to its potential outcomes and socioeconomic impact. Prenatal counseling is of major importance for parents because it is believed that the risk of preterm birth is associated with a higher parental mental burden. Nowadays in France, the content and delivery of antenatal counseling is based on personal experience since there is a lack of official guidelines. The goal of the study was to evaluate maternal perception of antenatal information delivered in the setting of premature births. Methods: A qualitative study was performed using semi-structured individual interviews of 15 mothers with a child born >26-34 GW. Data analysis was based on a constant comparative method. Results: We found that concerning prenatal counselling content, parents wanted to be informed of their role in the care of their premature child more so than statistics that were not always considered relevant. Parents’ reactions to the announcement of the risk of a premature birth was dominated by stupefaction, uncertainty and anxiety. When it comes to the setting of prenatal counselling, patients’ room was deemed an appropriate setting by parents and ideally the presence of a coparent was appreciated as it increased patients’ understanding. The physicians’ behavior during the counselling was considered appropriate and described as empathic and optimistic. The importance of support throughout the hospitalization in the form of other parents’ experiences, healthcare professionals and the possibility to preemptively visit the NICU was emphasized by participants. Delivery experience was dominated by a sense of uncertainty, and urgency. Some leads for improvement included additional support of information such as virtual NICU visit; participants also insisted on continuity of care and the multidisciplinary aspect of counselling (obstetrician, pediatrician, midwive, nurse, lactation consultant and psychologist). Conclusion: Overall general guidelines on prenatal counseling seem necessary, however personalization remains fundamental.

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Video Education in Early Pregnancy and Parent Knowledge of Neonatal Resuscitation Options

McDonnell,

Flynn,

McIntosh

et al. 2023

JAMA Netw Open

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Prenatal counseling for extreme prematurity at the limit of viability: A scoping review

Cited by 18 publications

References 38 publications

Two-year neurodevelopmental outcome in children born extremely preterm: the EPI-DAF study

Two-year neurodevelopmental outcome in children born extremely preterm: the EPI-DAF study

Qualitative analysis of mothers’ perception related to the delivery of information surrounding premature births

Video Education in Early Pregnancy and Parent Knowledge of Neonatal Resuscitation Options

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